Evaluating The Impact Of Prison Based Peer Workers On Hepatitis C Virus Screening In An Irish Prison

Author: Crowley D, Betts-Symonds G, Cullen W, Keevans M, Kelly E, Lambert JS, Halloran, Mc Hugh T, Mc Kiernan S, Murphy C, Miggin S Rice J, Van Hout MC

Theme: Social Science & Policy Research Year: 2017

Background: Hepatitis C Virus (HCV) infection is a major public health concern in prisoners. Global HCV prevalence in prisoners is estimated at 26%, increasing to 64% among those with a history of injecting drug use (IDU).There are 3,674 persons incarcerated in Ireland on any given day with an annual turnover of 14,182. The estimated prevalence of HCV infection in the Irish prison population is 27% increasing to 81 % in those with a history of IDU. HCV screening is suboptimal in prisoners with many barriers to uptake identified. Prison based peer work is associated with positive health gains and high levels of acceptance among prisoners and staff. The aim of this study was to evaluate the impact of engaging existing Irish Red Cross (IRC) inmate volunteer peer workers in the planning and implementation of a mass HCV screening initiative in an Irish prison.
Methods: A mixed method study using qualitative data collected from two prisoner focus groups (n= 28) and quantitative analysis of the uptake in HCV screening related to this initiative.
Results: Prisoners and IRC inmate volunteers identified prison based peer working as an enabler to HCV screening. Peer developed posters and leaflets were used to increase awareness and information around HCV. The involvement of peers reduced stigma and increased engagement with screening. Staff and prisoners expressed high levels of satisfaction with this approach. Over a two-day mass screening program 203 patients presented for screening, 67% (n= 137) of whom had not screened previously.
Conclusion: Identifying and unblocking the barriers to HCV screening is an essential public health strategy to reduce the HCV related disease burden carried by prisoners. The use of prison based peer workers to plan and implement HCV screening initiatives can significantly increase uptake. High levels of support among staff and prisoners further underpin the benefits.

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